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Consent and Capacity Board

Annual Report 2017-2018 (Fiscal Period – April 1, 2017 to March 31, 2018)

June 30, 2018

The Honourable Christine Elliott Deputy Premier and Minister of Health and Long-Term Care 80 Grosvenor Street 10th Floor Hepburn Block Toronto, ON M7A 2C4

Dear Minister:

Re: Consent and Capacity Board Annual Report for 2017/2018

I respectfully submit the 2017/2018 Annual Report of the Consent and Capacity Board pursuant to the Management Board of Cabinet Directive on Agencies and Appointments.

Yours sincerely,

Marg Creal Chair

Table of Contents Chair’s Message ........................................................................................................ 1

Mission, Mandate and Jurisdiction ............................................................................. 2

Organization .............................................................................................................. 5

Performance Measures .............................................................................................. 6

2016/2017 Accomplishments ..................................................................................... 8

Board Members’ Training and Professional Development ....................................... 12

Legal ........................................................................................................................ 14

Case Management ................................................................................................... 15

Appeals .................................................................................................................... 18

Finance .................................................................................................................... 19

Consent and Capacity Board Members ................................................................... 21

Members Reappointed in 2017/2018 using ATAGAA Waivers ................................ 26

______________________________________________________________________________________ Consent and Capacity Board – Annual Report 2017/2018 Page 1

Chair’s Message

I am pleased to report on the Consent and Capacity Board (CCB) for the fiscal year 2017/2018.

Once again the Board faced significant challenges impacting the nature of its work and membership. Application and hearing numbers steadily increased throughout the Province. The need for more adjudicators to meet the increased hearing demand together with membership losses due to adjudicator term limits created significant pressures on a part-time membership model. The Board initiated significant, province-wide membership recruitment across its five disciplines resulting in numerous appointments throughout the Province including the newly created “physician” and “nurse in the extended class” categories. Education and training were prioritized to facilitate fair, respectful timely and efficient high-quality hearings. Multiple training programs occurred to provide initial education and mentoring for many new appointees. Continuing professional development for members was strengthened by the addition of supports and educational programming on important subject areas.

Two experienced part time Vice Chairs were appointed as full time members to provide consistent adjudicative support and leadership to the Board. These newly created positions, along with the part time Vice Chairs from different disciplines and regions of the Province provide support to the Chair in strategic planning and decision making to promote excellence in adjudicative practices consistent around the Province.

Once again the CCB continues to meet its legislated requirements regarding scheduling hearings within seven days of receipt of an application, releasing decisions by the end of the day following the hearing and issuing written reasons within four business days.

I acknowledge and thank CCB staff for the delivery of efficient, timely and fair customer service to the public, and support for the membership. Staff members work tirelessly to ensure that the Board’s mandate and legal requirements are met.

I acknowledge and thank CCB members for the dedication, professionalism, compassion and fairness they demonstrate in the fulfillment of their duties. The decisions they reach have real, serious and lasting effects on the most vulnerable in our society.

Marg Creal. Chair


Mission, Mandate and Jurisdiction

Mission

To provide fair, timely, effective and respectful hearings that balance legal, medical and healthcare considerations while protecting individual rights and ensuring the safety of the community.

Mandate

The CCB is an independent administrative tribunal with a mandate to adjudicate on matters of capacity, consent, civil commital, substitute decision making, disclosure of personal health information and mandatory blood testing.

Jurisdiction of the CCB

The CCB is responsible for holding hearings and for making decisions on matters in which the least restrictive, least onerous and least intrusive decisions are made to:

1) maintain the safety of the individual 2) protect the safety of the community 3) maintain the dignity and autonomy of the individual

The CCB’s authority to hold hearings arises under the following legislation:

Health Care Consent Act

• Review of a finding of incapacity to consent to treatment, admission to a care facility or a personal assistance service;

• Consideration of the appointment of a representative to make decisions for an incapable person with respect to treatment, admission to a care facility or a personal assistance service;

• Giving directions on issues of treatment, admission to care facilities and personal assistance services;

• Consideration of a request for authority to depart from prior capable wishes of an incapable person;

• Review of a decision to consent to an admission to a hospital, psychiatric facility or other health facility for the purposes of receiving treatment;


•

• Review of a substitute decision-maker’s compliance with the rules for substitute decision-making; and

• Consideration of a request to amend or terminate the appointment of a representative.

Mental Health Act

• Review of involuntary status for a patient subject to a certificate of involuntary status, renewal of involuntary status or continuation of involuntary status

• Consideration of a request to order, vary or cancel specific conditions for an involuntary patient

• Review of a finding of incapacity to manage property;

• Review of whether a young person (aged 12 - 15) requires observation, care and treatment in a psychiatric facility; and

• Review of a Community Treatment Order.

Substitute Decisions Act

Review of a finding of incapacity to manage property.

Personal Health Information Protection Act

• Review of a finding of incapacity to consent to the collection, use or disclosure of personal health information;

• Review of a substitute decision maker’s compliance with the rules for substitute decision-making; and

• Consideration of the appointment of a representative to consent to the collection, use or disclosure of personal health information on behalf of an incapable person.

Mandatory Blood Testing Act

• If an individual has come into contact with another person’s bodily fluid, the individual can apply to the Medical Officer of Health to have a blood sample of the other person analyzed for HIV, Hepatitis B & C.


• If the Medical Officer of Health cannot obtain a voluntary blood sample or cannot locate the individual the Medical Officer of Health shall refer the application to the Board.

• The Board will decide whether the individual should be ordered to provide a blood sample.

Over 92% of applications to the CCB involve a review under the Mental Health Act of a person's involuntary status in a psychiatric facility or the criteria to issue a community treatment order, or a review under the Health Care Consent Act of a person’s capacity to consent to or refuse treatment.

The CCB meets its legislative obligations by:

• scheduling hearings within the required timeline

• issuing decisions and reasons within the required timelines

• adjudicating consistently and in a timely fashion

• issuing high-quality Decisions and Reasons for Decision, and

• creating an environment of respect for the adjudicative process, the parties and the public.


Organization

The CCB is an independent adjudicative Board created under the Health Care Consent Act with jurisdiction under that Act, the Mental Health Act, the Substitute Decisions Act, the Personal Health Information Proctection Act and the Mandatory Blood Testing Act.

The CCB had 162 members, as of March 31, 2018. In addition to the full-time Chair and two full time Vice Chairs, part-time CCB members include 9 Vice Chairs, 46 Lawyers, 45 Psychiatrists, 5 Physicians, 3 Nurses in the Extended Class and 51 Public members. Members of the CCB are appointed by Order-in-Council, for a term of one to five years. 15 employees of the Ontario Public Service support the work of the CCB and its members. Staff, including administrative, scheduling and legal staff, are responsible for functions such as: scheduling hearings, creating appeal records, managing hardcopy files, financial payment and processing, executive support to the Chair, coordinating member recommendations and appointments, organizing staff and member training, liaising with stakeholders, answering public inquiries, providing hearing support to panels, strategic planning, providing legal advice to the Chair and the Board, monitoring and ensuring compliance with legislation and government directives and policies.

As a quasi-judicial body, the CCB maintains an arm’s length relationship with the Ministry of Health and Long-Term Care while receiving administrative services and support through the Corporate Services Division. The CCB functions under statutory requirements and a Memorandum of Understanding between the Chair and the Minister of Health and Long-Term Care.


Performance Measures

Performance measures for the CCB regarding the scheduling of hearings, the issuance of decisions and written reasons are established by the Health Care Consent Act, 1996, Section 75 and are as follows:

1. The hearing shall begin within seven days after the day the Board receives the application, unless all parties agree to a postponement.

2. The Board shall render its decision and provide a copy of the decision to each party or the person who represented the party within one day after the day the hearing ends.

3. If within 30 days after the day the hearing ends, the Board receives a request from any of the parties for reasons for its decision, the Board shall, within four business days after the day the request is received,

(a) issue written reasons for its decision; and

(b) provide a copy of the reasons to each person who received a copy of the decision

The CCB consistently achieves these legislative requirements through its operational performance.

Hearings are conducted at up to 250 venues throughout the province, including hospitals, long-term care facilities and community locations. Due to the nature of the majority of the applications before the CCB, most hearings are held in Schedule 1 psychiatric facilities.

The CCB makes decisions with potentially serious consequences for individuals and for the community, such as detention in a psychiatric facility. The CCB adjudicates matters where both the medical and legal systems are engaged to provide treatment and protect individual rights. In addition, the CCB’s legislation requires that it hold a hearing within seven days of the receipt of an application issue decisions within one day of the conclusion of the hearing and issue written reasons within four business days when requested within 30 days after the day a hearing ends.

Given these performance measures, the CCB strives to ensure that its administrative and operational processes are consistent in achieving these goals.

The Board must ensure: • members receive ongoing educational and training opportunities to maintain

their expertise in this highly-specialized adjudicative environment;


• staff is highly trained and engaged and has the resources available to effectively and efficiently schedule hearings;

• it is providing informative and accessible educational information to stakeholders and parties;

• administrative processes support the achievement of the CCB’s mandate and deliverables


2016/2017 Accomplishments

Stakeholder Consultation, Outreach and Education

1. In 2016/2017 the CCB met with numerous organizations and participated in discussions of mutual interest. The organizations included the Ministry of Health and Long-Term Care, Ministry of Children and Youth Services, Legal Aid Ontario, the Psychiatric Patient Advocate Office and the Law Commission of Ontario.

2. The CCB continued to meet with two key stakeholder committees in 2017/2018. The first involves psychiatrists in the Toronto and Southwest Regions that generally represent themselves at CCB hearings. The second includes counsel that represent applicants and physician parties before the CCB. Each committee meets quarterly. In addition the CCB met with party stakeholders in Kingston and Ottawa. These meetings provide an opportunity to communicate on issues of mutual interest and have proven to be an effective tool for sharing information and gathering feedback.

3. The CCB continued its public information program in response to requests to educate parties to CCB hearings, counsel and stakeholders about the roles and responsibilities of the Board, its processes and associated implications for healthcare professionals and individuals. These presentations are designed to assist persons who appear before the CCB to communicate with Board personnel, effectively prepare for and participate in CCB hearings. This CCB initiative promotes good relations with the Board and high quality hearings. In 2017/2018 17 programs were delivered to stakeholders including lawyers, professional continuing education attendees, health care professionals, administrators, government organizations and social workers

Effective Hearing Management

1. In response to an increasing caseload and with the addition of amendments to the Mental Health Act in relation to long-term detention, in 2015/2016 the CCB initiated a case conferencing process to those matters to manage the identification of applications to be brought, legal issues and the parties to the hearing. Since this time the use of case conferences, also referred to as prehearings, was expanded more broadly across the CCB’s caseload. In 2017/2018 total of 327 conferences were convened. The use of case conferences helps to promote both the responsible use of resources and enhanced service to parties by ensuring that complex matters proceeding to hearing are well positioned to convene and conclude in an effective and timely fashion.


2. In February 2017 the CCB initiated a new pilot project to ensure the timelier sharing of documents with parties and the Board and to promote the effective use hearing time. Further details of this pilot project, which is ongoing, can be found in the Legal section of this Report.

Recruitment, Training, Continuing Education and Quality Assurance

1. In 2017/2018 the CCB conducted eight recruitment competitions for Vice-Chairs and Lawyer, Psychiatrist, Physician, Nurse in the Extended Class and Public Members. Recruitment, merit-based interviews and recommendation of new members were conducted in accordance with the requirements of the Adjudicative Tribunal Accountability Governance and Appointments Act. In 2017/2018 40 new members were appointed to the CCB, ten lawyer, four psychiatrist, two physician, three nurse in the extended class and 21 public members. Additionally, three existing members were reappointed as Vice Chairs.

2. The CCB conducted its new member training program which includes hearing observation, classroom training and participation on hearing panels with experienced member mentors. In 2017/2018 four classroom training sessions were held, in which 40 new members were trained and mentored. This was a significant endeavor resulting in the preparation of approximately 25% of the CCB’s total membership for assuming its adjudicative responsibilities and required significant membership and staff resources to implement.

3. The CCB continued to assess the performance of members through an enhanced member Performance Evaluation Program (PEP). This Program monitors the quality of adjudication and requires the evaluation of each member once during the term of his/her Order-in-Council appointment. In 2017/2018 the CCB conducted 26 PEP reviews.

4. In addition to PEP reviews the CCB has initiated mechanisms to review each order/ endorsement and set of Reasons released to assess individual education or support needs and systemic needs.

5. In response to the increasing complexity of matters before the CCB, and the appointment of a significant number of new members, the Board expanded and enhanced its in-service training program in 2017/2018. Further details on member training programs can be found in the Board Members Training and Professional Development section of this Report.


Scheduling and Administration

1. The CCB continues to expand the use of videoconference technology to convene hearings. Videoconferencing enhances the Board’s ability to provide effective service to parties throughout the province, while efficiently managing public resources. Use of this technology also supports green strategies by reducing the environmental impact of travel. Videoconference hearings have gained wide acceptance among CCB stakeholders and members alike. As a member of the Ontario Telemedicine Network (OTN) there is no additional cost to the Board to convene hearings by videoconference, however the Board’s ability to continue to maintain or expand the use of OTN depends on the availability and cooperation of health care facilities throughout the province.

In 2010/2011, the first full calendar year during which the Board was a member of OTN, the CCB scheduled seven hearings in remote communities by videoconference. This represented 0.2% of all hearings that year. In 2017/2018 the Board convened over 1000 hearings, or approximately 20% of all hearings using OTN videoconferencing.

Videoconference technology has become a mainstream scheduling tool and has enabled the CCB to meet its mandate while continuing to manage increasing caseload. As use of videoconference continues to expand, the CCB remains responsive to feedback from internal and external stakeholders and efforts are always underway to both streamline and enhance the experience for parties, adjudicators, facilities and Board staff.

2. As the demand for hearings has increased there has been a need for the Board to be nimble and innovative in the scheduling of hearings in order to provide access to justice for all applicants. The Board has long managed the reduced timelines associated with statutory holidays by carefully scheduling hearings based on location and available adjudicative resources to ensure that all hearings can successfully convene. In 2015/2016 the Board began to look toward this model to help manage the hearing schedule from time to time during periods of particularly high demand. In 2017/2018 the Board adopted this approach for most hearings in the highest volume areas of the province. This approach provides for the earliest possible notice to parties to allow for hearing preparation or to request rescheduling, encourages cooperation between parties with respect to mutual requests to reschedule hearings, makes responsible use of public funds and ensures adjudicative, ancillary service, and support resources are in place for all hearings province-wide

3. The CCB is statutorily obligated to prepare and serve a record of appeal, including a transcript of proceedings, upon receipt of a Notice of Appeal from a party. Administrative staff are responsible for the physical preparation of appeal


records and for arranging service to the parties and court. In 2017/2018 94 appeals notices were received. While this is down somewhat from the previous year and consistent with 2015, it is a 42% increase from 2014.

4. Administrative staff provided support to an expanded member recruitment and training program through the coordination of 41 member applicant interviews. Administrative support was provided to 23 in-year member training sessions where 313 members received training and an all member education session where 128 members were trained.

5. Finance staff continue to pursue efficiencies which allow them to absorb increased workload resulting from hearing volume and corporate changes. In 2017/2018 improvements were made to financial training for new members, claim forms were revised to automate calculations and coding, and vendor invoicing was consolidated. These changes resulted in improved processing within the financial team and allow staff to continue to provide excellent service to members, while ensuring compliance and accountability with respect to the use of public funds.


Board Members’ Training and Professional Development

Member training is a priority for the CCB. CCB members are required to perform at the highest level of skill to ensure that the correct decision is made, and proper procedures are followed.

The CCB has a comprehensive training program for new and existing members which includes a new member education session, a mentoring program, a performance evaluation program and annual training sessions. The extensive training provided to members ensures the CCB has well-trained and qualified adjudicators.

In recognition of the need to continually review, revise and deliver new training, in 2017/2018 a Vice-Chair was designated to focus on member education initiatives.

New Member Education

The CCB provided new member training to 36 new members in 2017/2018. This training consisted of a two day session to provide an overview of role of the member, and the legislation, rules and policies that are relevant to the work of the CCB. New members were also paired with an experienced mentor who participated in training panels with them and provided advice and guidance during the training period.

New Presiding Member Supplemental Training

The CCB introduced New Presiding Member Supplemental Training in recognition of increasing hearing complexity, heightened demands on Lawyer members and the significant number of new Lawyer members. This training was provided twice in 2017/2018 to 11 Lawyer members.

Issue Specific Training

Ongoing training on key issues has been provided over the last year. Mandatory training was delivered to Lawyer members on Form C applications and separately to Public and medical members. MHA Amendment training was provided to new appointees, and Community Treatment Order updates were also provided. Supplemental training was delivered to new presiding Lawyer Members. A session on mentoring new members was delivered to mentors to ensure consistent strategies for training new members. Performance Evaluation Program evaluators also received training. Overall 23 sessions were provided to 313 members in 2017/2018.


All Member Education Session

In addition to the various topic, region, and sector specific training sessions conducted throughout the year, the Board held an all member education session in October 2017 to provide collective educational and training opportunities for all members. The theme of the full day education session was “Professionalism – Moving Forward”

The session brought together Board members from across the province to receive legal and practical education and share best practices to ensure the Board can provide consistent and high quality adjudication services across the province. The all member education session also provided an opportunity for members from all regions in Ontario to meet face-to-face and engage in peer-directed learning and discuss issues that affect hearing proceedings in all regions with a view to finding mutually beneficial resolutions.


Legal

Obligation re: Disclosure of Medical or Health Record under s.76 of the Health Care Consent Act, 1996

Under s.76 of the Health Care Consent Act, 1996 (HCCA), counsel representing a person in a Consent and Capacity Board hearing have a legal right to examine and copy their client’s medical or health records, subject to some exceptions. Section 76 states:

76 (1) Examination of documents. — Before the hearing, the parties shall be given an opportunity to examine and copy any documentary evidence that will be produced and any report whose contents will be given in evidence.

(2) Health record. —The party who is the subject of the treatment, the admission or the personal assistance service, as the case may be, and the person authorized under the Law Society Act to represent him or her are entitled to examine and to copy, at their own expense, any medical or other health record prepared in respect of the party, subject to subsections 35 (6) and (7) of the Mental Health Act (withholding record of personal health information), subsections 33 (2), (3) and (4) of the Home Care and Community Services Act, 1994 (withholding record of personal health information) and subsections 294 (2) to (6) of the Child, Youth and Family Services Act, 2017 (withholding record of mental disorder). 2004, c. 3, Sched. A, s. 84 (11); 2006, c. 21, Sched. C, s. 111 (3); 2007, c. 8, s. 207 (16); 2017, c. 14, Sched. 4, s. 16 (1).

The issue of counsel encountering challenges in obtaining their client’s medical or health records, in order to represent them at CCB hearings, has arisen in the past. In an effort to provide some guidance and assistance on this issue, some years ago the Board posted information on this legal obligation on its website.

In this past year, the obligation to provide the medical and health records under s.76 of the HCCA, within the context of emerging and complex electronic health records systems, has arisen in CCB hearings. In one case, the Board issued an Order/Endorsement [BD (Re), 2018 CanLII 44315 (ON CCB)], which confirmed the obligation to provide counsel with access to the medical and health record, under s.76 of the HCCA, where the information is housed within an electronic health records system. The Board emphasized the importance of this obligation in order to ensure that counsel have an opportunity to review the medical and health record, and that applicants before the Board have the ability to adequate instruct counsel, prior to their hearing before the CCB. The Board noted that this obligation needs to be met within a reasonable period of time, in light of the legislative obligations in the HCCA to hold a hearing within seven days


Case Management

Caseload Increase

The CCB has a legal obligation to accept and process all applications submitted and convene hearings within statutory timelines. Caseloads have been steadily increasing since the consolidation of regional operations to a centralized office in 2002/2003, and the increases have been greater in recent years. In the five years following centralization applications increased 22% and hearings increased by 8%. However in the past five years applications have increased 35% and hearings have increased 59%.

For the 2017/2018 fiscal year application receipts climbed over 8000 and nearly 5000 hearings were convened province wide. This is a 120% increase in applications and a 152% increase in hearings since centralization.

Caseload Increase

1500

2000

2500

3000

3500

4000

4500

5000

5500

6000

6500

7000

7500

8000

8500

Applications Hearings

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Applications to the Board

In 2017/2018 a total of 8076 applications were received by the CCB. Three types madee up the majority of the applications submitted to the CCB: 46% related to a review of involuntary status, 26% related to a review of a finding of incapacity with respect to treatment, admission or personal assistance and 21% related to a review of a Community Treatment Order.

Application Types Received 2017/2018

Involuntary Status 44%

Capacity (trt/adm/pers.assist.)26%

CTO 23%

Capacity (property) 3%

Appoint Representative 1.6%

Compliance with principle ofsubstitute decision making0.5%Other 2%

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Applications Reviewed at Hearings

In 2017/2018 a total of 4922 hearings were convened by the CCB. The majority of hearings involved a review of three types of applications: 89% of all hearings involved an application with respect to involuntary status, 63% involved an application with respect to a finding of incapacity with respect to treatment, admission or personal assistance and 46% involved an application with respect to a Community Treatment Order. Note that the total is greater than 100% because more than one application may be reviewed at a single hearing.

2017/2018Percentage of Total Hearings by Application Type

Involuntary Status 89%

Capacity to Consent(Treatment/Admission/Personal Assistancce)

63%

Community Treatment Order 46%

Capacity to Consent (Property) 8%

Appoint Representative 8%

Other 7%

Compliance with Principles of Substitute DecisionMaking

3%

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Appeals

A party to a proceeding before the CCB has the right to appeal the CCB’s decision to Ontario’s Superior Court of Justice within seven days after receipt of the CCB’s decision. The CCB is responsible for preparing the record of proceedings and ordering the transcripts for the hearing in question. These documents are then served on the parties and filed with the court.

The following are the number of appeals received by the CCB and their outcomes at the Court level. The appeal information is based on calendar year, not fiscal year. Note, appeal outcomes may not correspond to the calendar year the appeal was initially filed.

YEAR WITHDRAWN/ ABANDONED DISMISSED ALLOWED

NO INFORMATION/ OPEN CASES

ADMINISTRATIVELY CLOSED BY CCB TOTAL

2003 27 8 2 7 12 562004 20 6 0 7 4 372005 21 11 3 10 4 492006 25 16 0 7 2 502007 27 16 0 12 5 602008 18 16 0 10 0 442009 14 9 3 15 5 462010 27 19 1 1 10 582011 30 18 4 4 7 632012 23 12 2 10 2 492013 23 19 1 16 3 622014 21 26 4 9 6 662015 31 29 6 25 4 952016 39 25 3 54 2 1232017 25 8 1 57 3 94


Finance

The financial unit exercises prudent fiscal controllership by ensuring all member claims and vendor invoices adhere to Board and government guidelines and directives.

For many years the CCB’s budgetary allocation was both static and less than the actual expenditures required to address its legislated mandate. From 2008/2009 to 2014/2015 the CCB’s allocation was fixed at $4,800,700. Historically, the CCB has experienced annual pressures of approximately $1 - $1.5M since 2000/2001 due primarily to an ongoing increase in caseload, a factor over which the CCB has limited control.

In the 2015/2016 fiscal year the CCB’s allocation was revised to $6,710,700, which was a 40% increase over previous years and exceeded the actual expenditures of any previous year. The increase was fully contained within Other Direct Operating Expenses (ODOE), with no additional allocation provided for Salary & Wages, where a deficit remained. For 2017/2018 the allocation remained the same but was subject to a 5% constraint target of $289,100.

Although actual expenditures continue to increase, they are outpaced by the increase in caseload. In the past 10 years actual expenditures increased 58% however the number of applications to the CCB increased 79% and hearings increased 134%.

In addition to increases in caseload, increases of approximately 11% to the set per diem rates for appointees introduced additional financial pressures which were not within the control of the CCB. Total per diem expenditures for part time appointees 2017/2018 were $5,856,830 and full time appointee salary and benefits were $436,781.

The CCB continues to review all aspects of its operations to enhance administrative efficiencies and to implement cost-savings or cost-avoidance strategies, as appropriate. The expansion of the use of videoconference hearings, for example, allows the Board to realize an estimated cost avoidance of between $1.5 - $2M annually through decreased per diem, travel and ancillary service provider costs. The Board also continues to execute an exceptional level of care and oversight in processing member claims. While the vast majority of the CCB’s ODOE expenditures are direct hearing-related costs, the CCB also carefully monitors other, smaller operational expenses with an eye toward continual improvement and cost efficiency. For example, recent minor purchasing adjustments identified by staff have prompted a 94% savings on one office supply item and 60% on another resulting in an annualized savings of over $2000 annually. While such efforts are small in scale, they demonstrate the CCB’s ongoing commitment to responsible management of all costs.


Financial Expenditure Report (April 1, 2017 to March 31, 2018)

Allocation Actual Expenditures

Surplus (Deficit)

DIRECT OPERATING EXPENSE Salaries and Wages 661,200 1,203,688 (542,488)Benefits 95,900 165,769 (69,869)

Subtotal $757,100 $1,369,457 ($612,357)

OTHER DIRECT OPERATING EXPENSES Transportation and Communications 360,000 441,146 (81,146)Services, including Accommodation 5,548,600 7,203,438 (1,654,838)Supplies and Equipment 45,000 33,086 11,914

Subtotal $5,953,600 $7,677,670 ($1,724,070)

TOTAL OPERATING EXPENSES $6,710,700 $9,047,127 ($2,336,427)

5% Constraint ($289,100)

TOTAL VARIANCE (with/ Constraint) ($2,625,527)


Consent and Capacity Board Members As of March 31, 2018

First Name Surname First Appointed Current Term Expires Chair

Ms. Marg Creal March 11, 2015 March 10, 2020Vice-Chairs

Vice-Chair (Full-Time Lawyer Member) Mr. Michael Newman September 01, 2017 August 31, 2019Ms. Lora Patton July 11, 2017 July 10, 2019Vice-Chair (Part-Time Lawyer Member) Mr. Paul DeVillers June 08, 2016 December 31, 2018Ms. Judith Jacob January 24, 2001 April 02, 2020Ms. Carolyn Jones June 22, 2016 December 31, 2018Vice-Chair (Part-Time Psychiatrist Member) Dr. Rajiv Bhatla April 04, 2007 March 31, 2020Vice-Chair (Part-Time Public Member) Mr. Earl Campbell July 17, 2013 December 31, 2018Ms. Barbara Laskin November 29, 2017 November 28, 2019

Ms. PatriciaMuldowney-Brooks June 30, 2016 December 31, 2018

Mr. Paul Philion April 13, 2016 December 31, 2018Mr. Gary Strang January 15, 2016 January 14, 2021

Lawyer Members Mr. Normand Forest December 12, 2001 December 11, 2018Mr. Michael Hennessy August 21, 2003 August 20, 2019Mr. Bernard Comiskey November 02, 2005 November 01, 2019Mr. Eugene Williams January 05, 2006 January 04, 2019Ms. June Bell September 06, 2006 September 05, 2018Mr. Brendon Pooran February 22, 2011 February 21, 2021Ms. Sally Bryant April 18, 2011 April 17, 2021Ms. Elisabeth Margaret Bruckmann June 20, 2012 June 19, 2022Mr. Lonny Rosen July 18, 2012 July 17, 2022Ms. Rekha Lakra May 08, 2013 December 31, 2018Ms. Nina Lester June 17, 2009 June 16, 2019Ms. Suzanne Clapp October 30, 2013 October 29, 2018Mr. Michael Horan March 19, 2014 March 18, 2019Ms. Ronda Bessner August 13, 2014 August 12, 2019Mr. Frederick Chenoweth January 28, 2015 January 27, 2020


Ms. M. Krista Bulmer April 15, 2015 April 14, 2020Mr. Robert Karrass November 04, 2015 November 03, 2020Mr. Glenn Stuart November 04, 2015 November 03, 2020Mr. Ronald Franklin December 02, 2015 December 01, 2020Ms. Winnie Tse December 02, 2015 December 01, 2020Mr. Shashi Raina December 09, 2015 December 08, 2020Mr. Brian Chillman January 15, 2016 January 14, 2021Ms. Diane Ewer January 15, 2016 January 14, 2021Mr. John Hanbidge January 15, 2016 January 14, 2021Mr. John Liddle January 15, 2016 January 14, 2021Ms. Linda Martschenko January 15, 2016 January 14, 2021Mr. Ross Stewart February 24, 2016 February 23, 2021Mr. Geoffrey Beasley May 18, 2016 May 17, 2021Ms. Loree Hodgson-Harris May 18, 2016 December 31, 2018Ms. Laura Silver May 18, 2016 December 31, 2018Ms. Miriam Vale Peters May 30, 2016 December 31, 2018Mr. Daniel Ambrosini June 22, 2016 December 31, 2018Ms. Jessyca Greenwood September 14, 2016 September 13, 2018Ms. Brigitte Pilon April 26, 2017 April 25, 2019Ms. Sonya Jain May 10, 2017 May 09, 2019Mr. David Cavanaugh May 31, 2017 May 30, 2019Ms. Joanne Lau May 31, 2017 May 30, 2019Mr. Timothy Power July 11, 2017 July 10, 2019Mr. Graham Reynolds July 11, 2017 July 10, 2019Ms. Elizabeth Harvie August 17, 2017 August 16, 2019Mr. Joseph Nemet August 17, 2017 August 16, 2019Ms. Zeenath Zeath March 07, 2018 March 06, 2020Ms. Mary Jane Campigotto May 02, 2007 May 01, 2018Ms. Delia Lewis May 10, 2017 May 09, 2019Ms. Kathleen Gowanlock April 15, 2015 April 14, 2020Mr. Bernard Starkman February 27, 2002 May 03, 2018

Nurse Members Ms. Nicole Basiaco May 10, 2017 May 09, 2019Ms. Stacey Bricknell April 26, 2017 April 25, 2019Ms. Kate Uchendu May 31, 2017 May 30, 2019

Physician Members Dr. Donald Jamieson December 20, 2016 December 19, 2018Dr. Taylor Lougheed December 20, 2016 December 19, 2018Dr. Kashif Pirzada January 11, 2017 January 10, 2019


Dr. Laurie Wells May 18, 2017 May 17, 2019Dr. Katherine Whitehead April 12, 2017 April 11, 2019

Psychiatrist Members Dr. Nural Alam January 13, 1999 January 12, 2019Dr. Yuri Alatishe March 19, 2014 March 18, 2019Dr. Halszka Arciszewska June 17, 2015 June 16, 2020Dr. Donald Braden October 06, 1999 October 17, 2019Dr. Robert Buckingham October 09, 2013 October 08, 2018Dr. Ranjith Chandrasena June 01, 1986 April 02, 2019Dr. Yoland Charbonneau August 23, 1993 April 02, 2022Dr. Peter Cook July 04, 2001 July 03, 2019Dr. JoAnn Corey August 17, 2017 August 16, 2019Dr. Padraig Darby June 28, 2017 June 27, 2019Dr. Virginia Edwards August 01, 2012 July 31, 2022Dr. Joseph Ferencz January 15, 2007 January 14, 2020Dr. Jane Fogolin February 26, 2014 February 25, 2019Dr. Alison Freeland May 30, 2006 May 29, 2019Dr. Donald Galbraith January 13, 1994 April 02, 2019Dr. Rose Geist February 27, 2008 February 26, 2021Dr. Balaji Gopidasan March 09, 2016 March 08, 2021Dr. R. Andrew Hackett March 18, 2015 March 17, 2020Dr. Karen Hand May 04, 2011 May 03, 2021Dr. Walter Hoe January 15, 2016 January 14, 2021Dr. Gary Kay September 08, 2015 September 07, 2020Dr. Catherine Krasnik August 01, 2012 July 31, 2022

Dr. Kanwal Deep Singh Kukreja October 21, 2015 October 20, 2020

Dr. Paul Links September 14, 2016 September 13, 2018Dr. Stephen List May 03, 2006 May 02, 2019Dr. Rahul Manchanda June 17, 1993 April 02, 2019Dr. Paul Max June 30, 2000 August 09, 2018Dr. Robert McCurley April 14, 2010 April 13, 2020Dr. Rosemary Meier June 01, 1986 April 02, 2020Dr. Jay Nathanson January 29, 2014 January 28, 2019Dr. George Papatheodorou November 04, 2015 November 03, 2020Dr. Sujay Patel October 02, 2013 October 01, 2018Dr. John Pellettier October 02, 2002 November 01, 2018Dr. Emmanuel Persad March 24, 2004 March 23, 2020Dr. Martina Power April 09, 2014 April 08, 2019Dr. Ajmal Razmy March 01, 2017 February 28, 2019


Dr. Gerald Shugar July 04, 2001 July 03, 2022Dr. Marvin Silverman July 11, 1990 April 02, 2020Dr. Peter Stenn November 06, 2013 November 05, 2018Dr. Cameron Stevenson June 05, 1996 June 04, 2022Dr. Varadaraj Velamoor May 31, 2017 May 30, 2019Dr. Albina Veltman July 11, 2017 July 10, 2019Dr. Samuel Waldenberg February 10, 2016 February 09, 2021Dr. Si-Ann Woods February 21, 2007 February 20, 2019Dr. Carolyn Woogh October 09, 2013 October 08, 2018

Public Members Mr. Nithy Ananth December 07, 2016 December 06, 2018Mr. Larry Brigham March 09, 2016 March 08, 2021Ms. Kim Brisson February 08, 2018 February 07, 2020Ms. Natasha Bronfman May 04, 2016 December 31, 2018Ms. Pat Capponi April 06, 2011 April 05, 2021Ms. Kimberly Cato August 17, 2017 August 16, 2019Ms. Deane Cornell June 30, 2016 December 31, 2018Ms. Deborah Cumming September 14, 2016 September 13, 2018Mr. James Cyr April 26, 2017 April 25, 2019Mr. Dwight Druick October 18, 2017 October 17, 2019Ms. Andrea Geddes Poole June 08, 2016 December 31, 2018Mr. Maurice Giroux July 11, 2017 July 10, 2019Mr. Harvey Gorewicz September 13, 2017 September 12, 2019Mr. Hamlin Grange February 09, 2011 February 08, 2021Ms. Janet Harris October 19, 2016 October 18, 2018Ms. Yvonne Harris October 18, 2017 October 17, 2019Ms. Jill Herne September 28, 2016 September 27, 2018Ms. Beverley Hodgson February 27, 2008 February 26, 2019Ms. Eva Hodgson March 07, 2018 March 06, 2020Ms. Ileen Howell February 17, 2010 February 16, 2020Mr. Slavo Johnson April 14, 2010 April 13, 2020Ms. Yasmin Khaliq August 17, 2017 August 16, 2019Ms. Sharon Krieger February 15, 2017 February 14, 2019Ms. Heather Lareau April 26, 2006 April 25, 2018Ms. Sandra LeBlanc October 26, 2005 October 25, 2018Ms. Sabita Maraj September 15, 2010 September 14, 2020Ms. Neasa Martin July 11, 2017 July 10, 2019Mr. David McFadden February 24, 2016 February 23, 2021Ms. Jane McIsaac September 14, 2016 September 13, 2018


Ms. Constance McKnight September 08, 2009 September 11, 2019Mr. Donald McLeod February 27, 2008 February 26, 2019Mr. Augustine Okon September 28, 2016 September 27, 2018Ms. Patricia Ostapchuk January 28, 2015 January 27, 2020Mr. Andrew Palmer July 11, 2017 July 10, 2019Mr. Henry Pateman November 01, 2017 October 31, 2019Mr. Simon Proops February 21, 2018 February 20, 2020Ms. Susan Qadeer October 21, 2015 October 20, 2020Mr. Robert Rainboth August 17, 2017 August 16, 2019Ms. Frances Rasminsky September 13, 2017 September 12, 2019Ms. Joyce Rowlands November 01, 2017 October 31, 2019Mr. Stephen Rudin November 16, 2016 November 15, 2018Ms. Trudy Shecter July 11, 2017 July 10, 2019Mr. Andrew Skrypniak February 24, 2016 February 23, 2021Mr. John Trainor March 07, 2018 March 06, 2020Mr. Timothy Vaillancourt December 05, 2012 December 04, 2022Ms. Barbara Van Der Veen August 04, 2016 August 03, 2018Ms. Claudia von Zweck August 17, 2017 August 16, 2019Ms. Debra Waisglass-Bettel October 26, 2005 October 25, 2019Ms. Mary Ward June 28, 2017 June 27, 2019Mr. Anthony Warr December 05, 2012 December 04, 2022Ms. Joy Wendling April 16, 2008 April 15, 2018


Members Reappointed in 2017/2018 using ATAGAA Waivers

First Name Surname First Appointed Current Term Expires

Vice-Chair (Part-Time Lawyer Member)

Ms. Judith Jacob January 24, 2001 April 02, 2020

Vice-Chair (Part-Time Public Member)

Mr. Gary Strang January 15, 2016 January 14, 2021

Lawyer Members

Ms. Elisabeth Margaret Bruckmann June 20, 2012 June 19, 2022

Ms. M. Krista Bulmer Bulmer April 15, 2015 April 14, 2020

Ms. Mary Jane Campigotto May 02, 2007 May 01, 2018

Mr. Brian Chillman January 15, 2016 January 14, 2021

Ms. Diane Ewer January 15, 2016 January 14, 2021

Mr. Ronald Franklin December 02, 2015 December 01, 2020

Ms. Kathleen Gowanlock Gowanlock April 15, 2015 April 14, 2020

Mr. John Hanbidge January 15, 2016 January 14, 2021

Mr. Robert Karrass November 04, 2015 November 03, 2020

Ms. Michele Lawford September 15, 2010 September 14, 2017

Mr. John Liddle January 15, 2016 January 14, 2021

Ms. Linda Martschenko January 15, 2016 January 14, 2021

Mr. Shashi Raina December 09, 2015 December 08, 2020

Mr. Lonny Rosen July 18, 2012 July 17, 2022

Mr. Ross Stewart February 24, 2016 February 23, 2021

Mr. Glenn Stuart November 04, 2015 November 03, 2020

Ms. Winnie Tse December 02, 2015 December 01, 2020

Psychiatrist Members

Dr. Halszka Arciszewska June 17, 2015 June 16, 2020

Dr. Yoland Charbonneau August 23, 1993 April 02, 2022

Dr. Virginia Edwards August 01, 2012 July 31, 2022

Dr. Rose Geist February 27, 2008 February 26, 2021


Dr. Balaji Gopidasan March 09, 2016 March 08, 2021

Dr. Walter Hoe January 15, 2016 January 14, 2021

Dr. Gary Kay September 08, 2015 September 07, 2020

Dr. Catherine Krasnik August 01, 2012 July 31, 2022

Dr. Kanwal Deep Singh Kukreja October 21, 2015 October 20, 2020

Dr. Helen Rosemary Meier June 01, 1986 April 02, 2020

Dr. George Papatheodorou November 04, 2015 November 03, 2020

Dr. Gerald Shugar July 04, 2001 July 03, 2022

Dr. Marvin Silverman July 11, 1990 April 02, 2020

Dr. Cameron Stevenson June 05, 1996 June 04, 2022

Dr. Samuel Waldenberg February 10, 2016 February 09, 2021

Public Members

Mr. Larry Brigham March 09, 2016 March 08, 2021

Ms. Beverley Hodgson February 27, 2008 February 26, 2019

Ms. Barbara Laskin February 10, 2006 February 09, 2018

Mr. David McFadden February 24, 2016 February 23, 2021

Mr. Donald McLeod February 27, 2008 February 26, 2019

Ms. Susan Qadeer October 21, 2015 October 20, 2020

Mr. Andrew Skrypniak February 24, 2016 February 23, 2021

Mr. Timothy Vaillancourt December 05, 2012 December 04, 2022

Mr. Anthony Warr December 05, 2012 December 04, 2022

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